Thursday, July 23, 2009

First Thoughts

If you've been following along, I have no need to explain what today was. Overall, I'd say that the first day played out as expected, but that it's an interesting feeling to think about what it signifies. While I am truly no different than I was this morning or yesterday or two weeks ago (or really than I will be in another two weeks), there is a marked change in the potential to which I can- or am expected- to reach.

*Warning: the following will be a lot of my thoughts on the current state of health care. Read at your own risk*

The deans and higher-ups payed much attention to the status of the profession of medicine and how "we" operate/fit in society (I use 'we' to encompass the working members of the health care field- and don't worry, it still freaks me out to include myself in that definition). Not in the sense of a higher status than others, but in the sense of obligation and trust. Physicians- and all professionals (traditionally medicine, law and clergy)- operate out of the basic trust that society gives them. People surrender their sovereignty and judgment to doctors under the expectation that they work toward the greater good and only on the best interest of the patient. A doctor's power stems from this trust and if such a valuable thing isn't acknowledged and upheld it can (theoretically) be revoked.

The presentation made me think about the current issues of health care reform/insurance/cost/problems. Can we in the profession, by allowing it to get to the state it is in now, be held responsible for the current problems? Has the social contract been broken through the acceptance of a third party (being insurance/pharmaceuticals) in the patient-physician relationship? And if this is the case (which I believe it is), have we progressed so far that the power of the patient to revoke the social agreement has been made obsolete?

It's a big debate and a huge question. My thoughts will follow and don't worry, I know I'm mostly dreaming I believe we must (with all others- patient/administrator/insurance/pharmaceutical/government) be held accountable to the current problems and need to be instrumental in reform. Insurance companies need to stop focusing on charges and focus on costs. There's a huge difference between the two. Pharmaceutical companies need to quit worrying about patents and shift from a business-focus to a public-good-focus through providing affordable drugs. Patients need to accept the fact that the system isn't perfect, cannot be ruled by the market alone and that they cannot always get everything they want. The system exists with a finite number of resources and (I know this is shocking to hear) some rationing and restrictions must be made. From a med school/student view, I honestly think there needs to be restrictions on specialties and residency programs. There's an astounding shortage of primary care doctors, and too many people need a dedicated and gate-keeping primary care doctor to focus on preventative and consistent care to keep churning out the wonky ratio of primary care/specialist docs that we are now (32%/68%- and that's being generous. Read here). It's a nasty thing to hear (particularly from a med student perspective) and I don't know if it'll ever happen. Just like patients being regulated to specific doctors, med students don't like to have their choices restricted. It goes against the ingrained nature of the American ideal: freedom of the individual.

*End of thoughts of current state of health care*

Wow. If you read all that, bravo. I commend you. If anyone has any questions or wants a discussion, I'm all for it. If you want to really get a good look at this, read The Social Transformation of American Medicine by Paul Starr. It'll rock your world. As for the actual happenings of the day, we got a sweet computer (which I'm currently posting from) and found out some (kind-of) interesting information about student services (health center/rec/study options/etc).

In closing, so that everyone knows exactly where I stand on the health care ladder, I can be referred to (and should call myself) a student-doctor. I feel like some kind of awkward teenage of medicine. Also, there's no way that I'm the only one who thinks the phrase "patient-contact" (used to note situations where we'll encounter patients) conjures images of discovering a new alien species.

Dean: Everyone dress business casual tomorrow, as we'll be having patient-contact on the trip to Wichita.
Student: Should we expect hostiles or friendlies, sir? Do they look human in nature?

Wednesday, July 22, 2009

Too Accurate

I was going to write a legitimate post. Was. I read this and proceeded to laugh so hard that now I can't do it. Most people probably won't see the same hilarity I do, likely because they- unlike me- are not wholly represented by the man in the comic.

Until next time.

(Orientation tomorrow!)

Tuesday, July 21, 2009

Lest I Forget

Things to remember (or be reminded of):
I chose to be a doctor and want to learn medicine. For all of the debt, time-sucks, struggles and stresses I will face as a med student, let me remember that I chose this path and for good reason. While I might get fed up with the hours, the tediousness, the paperwork, the emotions, the unruly patients, the failure, the system/bureaucracy, and the general downside of it all, let me use that frustration to highlight the immense potential for good this profession will allow me. I do not know exactly what I am getting myself into, but let me accept and experience it all together; appreciate it all; use it all.

Never think yourself better or more deserving than another.

Everyone deserves care (there's a reason you like the idea of a SP Universal system).

Be humble and intelligent enough to say, "I don't know."

Never discount the small victories or joy taken from something, even if others find it insignificant.

Always strive to learn more, be it from a class, a patient, a colleague, or a mistake.

Things to remember from someone who knows more than me and has done it for years:
-Keep your head on straight.
-You have the tools.
-Don't be dazzled by bullshit.
-Separate facts from fiction and "conventional advice."
-Make sure all things pass the smell test for veracity, virtue, and truth.
-Have fun.


Now, in an ideal world, I'd never even have to look at this post because I will be so perfect in school and never doubt myself and things will be peachy and never difficult or rough and life will be fantastic and the sky will be made of Jello (and stop global warming, duh) and the ground of marshmallows and gummy bears and no one would get diabetes from living in a land of sugar.

I don't think so.

Thursday, July 16, 2009

D-Day Minus Seven

Today marks the beginning of the end for me.

Actually, that's not true. That's just melodrama. In one week, I will begin orientation for medical school. I am nervous, yes, but I am also really excited and worried and giddy and any other number of emotions. The spectrum of feelings comes from the unknown nature of what's to come. In a literal sense, I understand the entity of med school. I know that I'll have classes/tests/labs/etc and that I'll likely do just fine. I know people who are doing it now and who have finished. It is possible. Will it be a challenge (and by challenge I mean the hardest thing I've ever done)? Of course. But, I don't know (and I don't think you can know until you experience it) how I will handle life as a med student and the changes to myself and my life that come along with it.

Will my view of health care and what it should be in society change? My opinions and outlook concerning ethics and the obligations of others? There are big questions involved in starting something like this, or at least I imagine there to be. And lest we forget the other questions that inevitably arise: What will gross me out the most? Will I ever get used to the idea of people turning to me, the guy who builds fictional wooden cubes for fun and still routinely reads Calvin and Hobbes, for answers in huge life decisions?

I suppose more than anything, even with these questions and concerns, I'm still just really excited to start. I can only liken it to the first day of school, be it kindergarten or college. Right now the unknown still triumphs (although I suspect it always will) and I love the potential that exists. The thought of the amount of information I will learn (which will be but a fraction of what they teach) excites me and I think I'm as ready now as I'll ever be to begin.

But don't let me get ahead of myself. It's really the beginning of the beginning. I still have 7 days of freedom. I'm going to go read, play Xbox and make some chicken stir fry for dinner when my better half gets home. After I fold the laundry.

Wednesday, July 15, 2009

A New Test

People often assume, upon hearing that I'm going to med school, that I majored in the sciences "or something like that." I've been met with looks ranging from surprised pleasure to confused disdain after telling them that I did, in fact, major in English.

This blog stems out of that fact.

I majored in English, and while I start medical school soon (read: in approximately 1 week) I fear that my major will be, as so many people have said, irrelevant. While the specific focus/major of a person attending med school doesn't matter (only that they've completed the necessary pre-reqs), I don't want my English degree to be meaningless. As most people who know me can attest, I love to read. Perhaps to a level of obsession. I also love to write and just seem to love the English language in general. I don't want this passion/obsession to fall by the wayside while I plunge (or drown) headfirst into the murky sea of medicine. (Ignore the fact that the above explanation implies something falling...by the wayside...of a sea...that people swim in?)

The point is:

I want to write and think about language. To not lose what I've given so much time to thus far. So, I will attempt (for now) to chronicle my thoughts and experiences as a medical student here. I cannot promise you anything except that this blog will inevitably contain some pretty strange writings, and I assure you that my holding an English degree does not mean I will write well. Enjoy.